Ahmad Tarhini, MD, PhD, director, Melanoma and Skin Cancer Program, Center for Immuno-Oncology Research, Cleveland Clinic, discusses recent practice-changing clinical trials in melanoma.

Over the past year or so, there have been 3 positive studies testing adjuvant therapy in melanoma, 2 of which were presented at the 2017 ESMO Congress. CheckMate-238 tested the PD-1 inhibitor nivolumab (Opdivo) as adjuvant immunotherapy versus the standard ipilimumab (Yervoy) in patients with high-risk disease. Data showed that nivolumab significantly reduced risk of relapse for that patient population. An FDA approval for nivolumab in this setting soon followed these results.

The next study tested the combination of dabrafenib (Tafinlar) and trametinib (Mekinist) in patients with 

-mutated melanoma. Tarhini says there were unprecedented data from this study in terms of reducing risk of relapse. Most recently, data were presented from the KEYNOTE-054 study, which tested adjuvant pembrolizumab (Keytruda) in patients with high-risk surgically resected melanoma.

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Ahmad Tarhini, MD, PhD, director, Melanoma and Skin Cancer Program, Center for Immuno-Oncology Research, Cleveland Clinic, discusses some recent practice-changing clinical trials in melanoma.

Dr. Tarhini on Recent Practice-Changing Clinical Trials in Melanoma

Ahmad Tarhini, MD, PhD, director, Melanoma and Skin Cancer Program, Center for Immuno-Oncology Research, Cleveland Clinic, discusses adjuvant therapy for patients with melanoma.

Adjuvant therapy for melanoma is used in patients who are considered high risk for relapse or death, says Tarhini. For these patients, there is an indication to administer systemic treatment, which historically has been with interferon alpha. In 2015, ipilimumab (Yervoy) was approved for the adjuvant treatment of patients with melanoma. In April 2018, the FDA approved the combination of dabrafenib (Tafinlar) and trametinib (Mekinist) for the adjuvant treatment of patients with 

 V600E— or V600K–positive stage III melanoma following complete resection.

The problem with the currently available adjuvant treatment options have been the toxicity profiles, says Tarhini. Specifically, the cumbersomeness of interferon can negatively affect quality of life. Due to the toxicities, the survival advantage of interferon has been taken into question. In a recent analysis, Tarhini says that only a minority of patients will go onto receive adjuvant therapy after lymph node surgery—either with interferon or ipilimumab.  

Ahmad Tarhini, MD, PhD, director, Melanoma and Skin Cancer Program, Center for Immuno-Oncology Research, Cleveland Clinic, discusses adjuvant therapy for patients with melanoma.
 

Ahmad Tarhini, MD, PhD

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Dr. Tarhini on Recent Practice-Changing Clinical Trials in Melanoma

Dr. Tarhini Discusses Adjuvant Therapy for Melanoma